Document Detail


Prophylaxis of catheter-related bacteremia using tissue plasminogen activator-tobramycin locks.
MedLine Citation:
PMID:  19590902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This retrospective study was designed to investigate the effectiveness of tissue plasminogen activator-tobramycin antibiotic lock solutions (TPA/tobra ABLs) for prophylaxis of catheter-related bacteremia (CRB) in high-risk children on long-term hemodialysis. During the first 6 months (Era 1), the high-risk group was defined. These patients received TPA/tobra ABL prophylaxis after every hemodialysis treatment for the next 6 months (Era 2). The prophylaxis regimen was applied once a week for the third 6-months period (Era 3). Primary endpoints were CRB and infection-free catheter survival. There were 16,412 catheter days, and 95 cases of CRB in 43 children. The incidence of CRB was 5.8/1,000 catheter days. Significant decrease in the incidence of CRB was observed when prophylactic TPA/tobra ABL was used in the high-risk group (P = 0.0201). There was a tendency for less CRB when prophylactic ABL was applied after every hemodialysis session compared with once a week (P = 0.0947). The catheters in the high-risk group had shorter survival times than those in the average-risk group in Era 1 (P < 0.0001). However, both the overall and infection-free survival of the catheters in the high-risk group significantly improved while the patients were receiving TPA/tobra ABL prophylaxis, becoming similar to the outcomes of the catheters in the average-risk group and exhibiting statistically non-significant differences (P = 0.5571 and P = 0.9711, respectively). In conclusion, the TPA/tobra ABLs may effectively reduce the rate of CRB, and this may prolong both the overall and infection-free survival times of the catheters in the high-risk group.
Authors:
Ali Mirza Onder; Jayanthi Chandar; Anthony Billings; Nancy Simon; JoAnn Gonzalez; Denise Francoeur; Carolyn Abitbol; Gaston Zilleruelo
Publication Detail:
Type:  Journal Article     Date:  2009-07-10
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  24     ISSN:  1432-198X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-09-29     Completed Date:  2009-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2233-43     Citation Subset:  IM    
Affiliation:
West Virginia University, WVU/HSC, Morgantown, 26506-9214, USA. alim_md@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anti-Bacterial Agents / therapeutic use*
Calcium / blood
Catheter-Related Infections / prevention & control*
Child
Equipment Contamination / prevention & control
Female
Ferritins / blood
Hemoglobins / analysis
Humans
Isotonic Solutions*
Male
Parathyroid Hormone / blood
Phosphorus / blood
Renal Dialysis / adverse effects
Retrospective Studies
Risk Factors
Serum Albumin / analysis
Time Factors
Tissue Plasminogen Activator / therapeutic use*
Tobramycin / therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Hemoglobins; 0/Isotonic Solutions; 0/Parathyroid Hormone; 0/Serum Albumin; 32986-56-4/Tobramycin; 7440-70-2/Calcium; 7723-14-0/Phosphorus; 9007-73-2/Ferritins; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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